Calorie Count Plus Points Based on Added Sugars, Sodium, and Saturated and Trans Fats Recommended as New Front-of-Package Nutrition Labeling System

WASHINGTON — Federal agencies should develop a new nutrition rating system with symbols to display on the front of food and beverage packaging that graphically convey calorie counts by serving size and a "point" value showing whether the saturated and trans fats, sodium, and added sugars in the products are below threshold levels.This new front-of-package system should apply to all foods and beverages and replace any other symbols currently being used on the front of packaging, added the committee that wrote the report.

"Our report offers a path to develop an Energy Star® equivalent for foods and beverages," said committee chair Ellen Wartella, Sheikh Hamad bin Khalifa Al-Thani Professor of Communication, professor of psychology, and director, Center on Media and Human Development, School of Communication, Northwestern University, Evanston, Ill."A successful front-of-package nutrition rating system would enable shoppers to instantly recognize healthier products by their number of points and calorie information.It would encourage food and beverage producers to develop healthier fare and consumers to purchase products that are lower in calories and food components that contribute to chronic disease."

The report envisions a rating system in which foods and beverages earn points if their amounts of nutrients of concern -- saturated and trans fats, sodium, and added sugars -- are at or below levels considered acceptable based on qualifying criteria.The more points a food or beverage has, the healthier it is.A product could earn up to three points, one each for having sodium and added sugars that do not exceed threshold amounts and one for having saturated and trans fats below designated levels.For example, 100 percent whole wheat bread could qualify for all three points while graham crackers could earn two points for having levels of sodium and saturated and trans fats below the thresholds.Points would be graphically displayed on packaging as check marks, stars, or some other icon to be determined by the U.S. Food and Drug Administration.

Foods and beverages should pass a separate set of criteria to determine if they are eligible to earn points at all, the report adds.If a product exceeds the eligibility criteria for any one of the nutrients of concern, it would not be able to display any points.For example, a sugar-sweetened soda could not earn points for having low sodium and no saturated or trans fats because its added sugar content is too high.

Whether a food or beverage qualifies for points or not, it should prominently display the amount of calories per serving with servings described in familiar measurements, such as per slice or per cup.The front-of-package icons should also direct shoppers to the Nutrition Facts Panel on the reverse to get additional information about the healthfulness of products.

Although the committee's phase 1 report concluded that calories, saturated fat, trans fat, and sodium should be the focus of a new front-of-package system because they are most strongly associated with chronic disease, the phase 2 report says that added sugars should also be included.The 2010 Dietary Guidelines for Americans, which wereissued since the release of the first report, strongly recommend that people reduce their consumption of products that contain added sugars.The U.S. Department of Agriculture puts several products that are high in added sugars in a category called Sugars, Sweets, and Beverages; products in this group are automatically ineligible to earn points in the committee's recommended approach.

The new symbols representing products' calories and point values should appear on all grocery products so that shoppers can readily compare food choices within categories, such as breakfast cereals, as well as across categories, such as fresh produce, frozen vegetables, and canned soups, the committee said.Food manufacturers and retail outlets should display the symbols in consistent locations.

The report offers examples of what representative symbols and displays could look like purely for illustrative purposes.The committee does not endorse any particular graphic nor has it tested any of the examples in this report to determine their effectiveness.Likewise, the committee did not evaluate and assign points to all foods and beverages or categories of products.FDA will need to conduct these evaluations and develop and test potential icons and displays.Moreover, the agency should launch a consumer awareness and education campaign to promote the rating system and its graphic representation when they are finalized.Promotion, along with universal display on all products, is key to helping shoppers understand and take advantage of the new rating system, the committee said.

The study was sponsored by the Centers for Disease Control and Prevention, Food and Drug Administration, and U.S. Department of Agriculture Center for Nutrition Policy and Promotion.Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public.The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies. For more information, visit http://national-academies.org or http://iom.edu.A committee roster follows.